Yoshimoto A, Tsuji H, Takazakura E, Fujimura M
Department of Internal Medicine, Kurobe City Hospital, Mikkaichi 1108-1, Kurobe, Japan.
Nihon Kokyuki Gakkai Zasshi. 2001 Jun;39(6):405-9.
A 64-year-old man suffering from diabetic hyperosmolar non-ketotic coma was admitted for acute lung abscess in the left apical lung field. Sputum culture and blood culture showed a heavy growth of Klebsiella pneumoniae (K. pneumoniae). He was suffering from sepsis, septic pulmonary embolisms with cavities, bilateral pulmonary consolidations, and multiple liver abscesses. Gradually, the bilateral lung consolidations resolved and areas of consolidation were noted to undergo extensive cavitation bilaterally. Cavitation and abscess formation are frequent complications of K. pneumoniae. Generally, large bilateral lung abscesses caused by K. pneumoniae have a poor prognosis. Cavity nodules are often present in septic pulmonary embolisms. We report a very rare case in a patient with three types of cavities with differing mechanisms. The first was an acute lung abscess, the second, septic pulmonary embolisms with cavities, and the third, large bilateral lung cavities noted in the course of resolving consolidations.
一名64岁患有糖尿病高渗性非酮症昏迷的男性因左肺尖部急性肺脓肿入院。痰培养和血培养显示肺炎克雷伯菌（K. pneumoniae）大量生长。他患有败血症、伴有空洞的脓毒性肺栓塞、双侧肺实变和多发性肝脓肿。逐渐地，双侧肺实变消退，且实变区域出现双侧广泛空洞形成。空洞形成和脓肿形成是肺炎克雷伯菌的常见并发症。一般来说，由肺炎克雷伯菌引起的双侧大肺脓肿预后较差。空洞结节常出现在脓毒性肺栓塞中。我们报告了一例非常罕见的病例，该患者有三种不同机制的空洞。第一种是急性肺脓肿，第二种是伴有空洞的脓毒性肺栓塞，第三种是在实变消退过程中出现的双侧大空洞。
